Introduction

Disorders of audition stand at a crossroads between neurology, audiology, psychiatry and ENT. It is not uncommon for patients to ‘fall between the cracks’ of the referral pathway, and to become increasingly frustrated when specialties cannot decide who is responsible for them. The aim of this ‘How to understand it’ article is to demystify central auditory disorders for neurologists, and to show that they can be assessed like any other neurological symptom, based on a consideration of the anatomy and physiology of the auditory pathway. To illustrate this we describe the case history of a patient who had lost the ability to recognise and appreciate music who presented to an audiology clinician (DMB), who then sought neurology support (TEC, TDG). We elucidated the nature of the deficit in the analysis of sound patterns using psychophysics, but the deficits could have been predicted by a consideration of the anatomy and physiology of the auditory system.